Internet Journal of Airway Management

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Volume 4 (January 2006 to December 2007)


 

The Disposable Supreme Laryngeal Mask Airway with an Esophageal Vent

 

 

Ernst Zadrobilek, MD1

 

1Associate Professor of Anesthesia and Intensive Care, Chairman of the Austrian Working Group for Airway Management and Director of the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of Vienna, Vienna, Austria.

 

Address correspondence and comments to Ernst Zadrobilek.

 

Received from the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of Vienna, Vienna, Austria.

 

Published: June 30, 2007.

 


 

The correct citation of this communiction of new equipment and techniques is:

Zadrobilek E. The disposable Supreme Laryngeal Mask Airway with an esophageal vent. Internet Journal of Airway Management 4, 2006-2007.
Available from URL:
http://www.adair.at/ijam/volume04/newequipment03/default.htm
Date accessed: month day, year.

 


Last updated: December 20, 2007.


 

The reusable Proseal Laryngeal Mask Airway (PLMA; manufactured by the The Laryngeal Mask Company Limited, Le Rocher, Victoria, Mahe, Seychelles) with an esophageal drain tube (DT) has replaced the tracheal tube for airway management in many surgical procedures and may serve as a rescue device in situations of difficult face-mask ventilation and conventional tracheal intubation (1, 3). The Supreme Laryngeal Mask Airway (SLMA) was recently released by the same manufacturer as the disposable variant of the PLMA. The SLMA (made of polyvinyl chloride and moulded in a single unit, packaged sterile with a protective plastic case for the cuff) is currently available in the sizes 3 to 5.

 

The SLMA has a precurved cuff (larger than that of the PLMA, but without a second cuff attached to the dorsal face of the mask), a drain tube (DT; serving as esophageal vent), and an integrated bite block. The airway tube (AT) is elliptical (following the pharyngeal anatomy), flattened, and stiffened, and the distal cuff edge of the mask is reinforced (resisting folding), features designed for easier insertion and reliable placement of the device into the correct position. The DT is placed in the midline, passing through the AT, and ends at the distal tip of the mask.

 

Manual insertion of SLMA may be probably easier and placement into the correct position more reliable than with the PLMA. Unfortunately, there are currently no studies available on the clinical use and performance of the SLMA. The disposable SMLA may replace the reusable PLMA for use as a reliable supraglottic airway for ventilation, but this device is not suitable as an unique dedicated airway (2) because of the small and restricted lumen of the AT (unsuitable for tracheal inubation, even with a flexible fiberoptic laryngoscope mounted with an intubating catheter).

 

The costs of the SLMA are about 19 Euro (exclusive value-added taxes, according to the offer of the Austrian distributor, queried in December 2007).

 

 

References

  1. Brimacombe JR. ProSeal LMA for ventilation and airway protection. In: Brimacombe JR (ed) Laryngeal mask anesthesia. Principles and practice. Saunders, Philadelphia, p 505-537, 2005.

  2. Charters P, O'Sullivan E. The 'dedicated airway': a review of a concept and an update of current practice. Anaesthesia 54:778-786, 1999.

  3. Cook TM, Lee G, Nolan JP. The ProSealTM laryngeal mask airway: a review of the literature. Can J Anesth 52:739-760, 2005.


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